Serum levels of neopterin, tumor necrosis factor-alpha and Interleukin-6 in preeclampsia: relationship with disease severity

Eur Rev Med Pharmacol Sci. 2012 Nov;16(12):1707-12.


Aim: There are many studies evaluating the role of inflammation in the pathogenesis of preeclampsia. However, little is known about the relationship between the severity of inflammation and the severity of preeclampsia due to insufficient of studies reporting this matter. To investigate the maternal serum concentrations of IL-6, TNF-alpha and Neopterin in patients with mild preeclampsia and severe preeclampsia and HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome in preeclampsia and determine their association with the severity of the disease.

Patients and methods: Patients, hospitalized with the diagnosis of preeclampsia between October 2011 and March 2012, were included in the study. The patients with preeclampsia were divided into three groups as mild preeclampsia, severe preeclampsia and HELLP syndrome. The control group was comprised of normotensive and uncomplicated pregnant women. The serum levels of IL-6, TNF-alpha and Neopterin (NEO) were determined, using enzyme-linked immunosorbent assay. Spearman's rank correlation tests were used for the correlations between the serum levels of inflammatory markers and the severity of preeclampsia.

Results: There was no observed significant difference among mean serum TNF-alpha and IL-6 levels of four groups (p > 0.05). The median serum concentration of NEO in subjects with mild preeclampsia of 14.1 nmol/L and severe preeclampsia of 14.8 nmol/L was significantly higher than that of 10.3 nmol/L in normotensive controls (p = 0.013; p = 0.000 respectively). In addition, the median serum concentration of NEO was detected to be highest in subjects with HELLP syndrome. The serum levels of NEO was well correlated with the severity of preeclampsia (r = 0.533, p = 0.000).

Conclusions: The serum levels of NEO, an important marker of cellular immunity, associated with severity of disease in patients with preeclampsia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers / blood
  • Case-Control Studies
  • Enzyme-Linked Immunosorbent Assay / methods
  • Female
  • HELLP Syndrome / blood*
  • HELLP Syndrome / diagnosis*
  • Humans
  • Interleukin-6 / metabolism*
  • Neopterin / metabolism*
  • Pre-Eclampsia / blood*
  • Pre-Eclampsia / diagnosis*
  • Pregnancy
  • Severity of Illness Index
  • Tumor Necrosis Factor-alpha / metabolism*


  • Biomarkers
  • Interleukin-6
  • Tumor Necrosis Factor-alpha
  • Neopterin